Vaginal Hysterectomy
Prolapse Repair

Pre-op

  • Please follow the Pre-operative checklist page for more details.
  • Have your pre-op blood test 1 week before your surgery. If ECG is requested, please do the test.
  • Avoid constipation in the days leading up to your operation. If needed take a stool softener/laxative eg. Movicol, Fybogel.
  • Prepare for your post op recovery by stocking up your pantry and your freezer with some cooked meals since recovery may take several weeks

Post-op

  • After your surgery you will typically stay in hospital 1-2 nights, depending on your recovery. Before you go home, ideally you should be able to walk around slowly by yourself, tolerate normal drinking and eating, pass urine normally and have passed wind.
  • Make sure you have someone organised to stay with you to help you especially in the first 1-2 weeks post-surgery.
  • Continue your painkillers provided by the hospital regularly to keep your pain well controlled.
  • Bring your TED stockings home which are provided by the hospital and continue to wear them. They may need to be worn for up to two weeks until you are fully mobile again.
  • When sitting or lying down, exercise your feet and legs each hour when awake.
  • Keep your fluid intake up (especially water) and eat small amounts of diet until your appetite returns. Avoid constipation and straining. It is best to take a stool softener/laxative eg. Movicol, Fybogel until your bowel functions and regular.
  • An operation for a prolapse of the pelvic floor is done through your vagina so the stitches will usually be out of sight. Your stitches will not need to be removed as they are dissolvable.
  • Avoid excessive bending, lifting, Gym and heavy housework/strenuous activities for 6 weeks.
  • You will require 4-6 weeks leave from work, depending on your job. Gradually increase your usual level of activity as your body permits. It is perfectly safe to resume normal daily living activities – listen to your body.
  • Avoid intercourse for 8 weeks to allow complete healing of the vaginal incisions. Avoid swimming in a public pool for 2-4 weeks to reduce the risk of infections. Swimming in your own pool or ocean is acceptable.
  • Driving should be avoided for 3 weeks. Please check with your motor vehicle insurance provider prior to driving.

What to expect

Will I have pain?

Many gynaecological procedures are followed by some pain or discomfort. This should improve over time and can be managed with pain medications such as simple analgesia (eg: Panadol / Nurofen) for the initial 5-7 days. You will be given pain control medication in the hospital and to go home with. Most women will need the stronger pain medication from the hospital for the first 3-5 days after the operation. Severe pain is unusual and should be reported to our rooms.
Post operatively you may experience a moist vaginal discharge for 6-8 weeks. This will initially be blood stained, then may become pink/brown, and gradually change to yellow or white in colour. This is provoked by the vaginal incisions and the presence of suture material in the vagina. It is entirely normal and does not indicate infection. This will gradually reduce to nil as your internal wound heals. A pad may be used, but tampons should be avoided.
An operation for a prolapse of the pelvic floor is done through your vagina so the stitches will usually be out of sight. Your stitches will not need to be removed as they are dissolvable. You may notice a stitch, or part of a stitch, coming away after a few days or maybe after a few weeks. This is normal and nothing to worry about.
You may eat and drink normally. You may have a decreased appetite for the first few days after surgery; you may prefer to eat small, frequent meals. A high fibre diet may help to prevent constipation. However, if you are not able to eat or drink anything or if vomiting develops, call the hospital or the rooms.
Constipation is common after pelvic surgery and usually resolves with time and/or treatment. Wean off opioid pain medications if not needed as they may contribute to constipation. It is best to avoid constipation and straining by regular use of stool softeners or laxatives (eg: Coloxyl, Movicol etc) during the initial 1-2 weeks. If you do develop diarrhoea with the regular use of the laxatives, cease using them.
You may feel a pulling sensation during urination or stinging if the urine comes in contact with the vaginal stitches. If you have had an anterior vaginal repair, you may notice a change in the flow of your urine and that passing urine is slower and takes longer. This should settle with time. It can be normal to urinate frequently after surgery. However, if you are bothered by any urinary symptoms or do have a temperature, please call the rooms or the hospital.
Showers are permitted. Avoid using a public pool for a month to reduce the risk of infections. You may use your own bathtub or pool after 2 weeks.
Lifting heavy objects can increase stress on the healing tissues. For the first 4-6 weeks lift nothing greater than two kilograms. Increase gently as tolerated over six to eight weeks. It is best to avoid lifting heavy objects from the floor; if the object cannot be lifted with one hand, you should ask for help. You should also avoid squatting.
It is normal to feel tired for a few weeks after a major surgery. Taking a few short naps during the day or resting when you are tired may help. While rest is important, it is also important to walk around several times a day, starting on the day following surgery and build up gradually as able. When resting make sure to do feet/calf exercises and it is important to continue to wear the TED stockings for 1-2 weeks post operatively. These activities will help prevent complications, such as blood clots (DVT/Pulmonary embolism) and pneumonia. It is okay to do simple housework and climb stairs. You should avoid playing sports and doing heavy exercises in a gym environment for 6-8 weeks.
You should not drive a car for three weeks post operatively. You may ride in a car; as always, wear a seat belt. We do recommend avoiding long trips by car, train, or airplane during the first two weeks after major gynaecological surgery. Long-haul flights are to be avoided for 6 weeks to reduce the risk of thrombosis (DVT/ Pulmonary embolism).
After most types of gynaecological surgery, you should not put anything in your vagina until the tissues are completely healed. Otherwise, you may develop an infection or interfere with healing. This includes tampons, douches, fingers, and all types of sexual activity that involve the vagina. These activities should be avoided for 8 weeks after hysterectomy/pelvic floor repair. Following vaginal repair some discomfort is expected on recommencement of intercourse due to change in the anatomy as well as scar tissue formation. You may need to use additional lubrication.
If you were prescribed Vagifem pessaries/Ovestin vaginal cream to use pre-operatively you should recommence them approximately 2 -3 weeks after surgery. Speak to the Nurse if you are unsure. Following vaginal hysterectomy, you will not automatically need any additional hormone therapy.
You may feel fatigued. You will require up to 4-6 weeks off work to allow appropriate recovery. Time off work also depends upon your daily activities at work; a person who sits at work may be able to return to work sooner than someone whose job requires them to stand, walk, or lift. You should have returned to normal activity within two to three months, although full recovery may take longer in some circumstances, this is usually uncommon.

What post-operative follow up will I have?

  1. Dr Zachariah will visit you in the hospital on post-operative Day 1. A discharge plan will be made. Please remember, the least number of days in the hospital is the best for you.
  2. You will receive a call from Dr Zachariah’s rooms 5 -7 days after surgery to check on your condition. Carolyn, Dr Zachariah’s Nurse will discuss the pathology report if available. If you have any concerns, you may discuss with Carolyn.
  3. You will have a follow up appointment with Dr Zachariah in person 6 weeks after surgery. In the meantime, if you have any concerns, you may call or email the rooms. We will make every effort to resolve your concerns.

Potential Complications after discharge

  • You have heavy vaginal bleeding – heavier than a normal period.
  • You have offensive or abnormal vag  inal discharge.
  • You develop a fever i.e., temperature >380 C, or you are feeling unwell.
  • You have pain that is not relieved by simple analgesia.
  • Nausea and vomiting that is difficult to manage.
  • You are having difficulty passing urine or opening your bowels.
  • Swelling in an extremity (leg or arm) that is much greater on one side than the other.
  • Shortness of breath or chest pain.

Contact

  • For post-operative complications as listed above please contact Dr Zachariah’s rooms on 08 9389 5000.
  • During out of hours or weekends please call Hollywood Hospital Switch board on 08 9346 6000 and ask to speak with the Nurse Co-ordinator who will liaise with Dr Zachariah.
  • For non-urgent matters, please contact your GP.
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